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Managed Care February 2006	Managed Care Offered to More Medicaid Enrollees A chart illustrates the percentage of medicaid enrollees in managed care, for the years 1996 to 2004.
Managed Care August 2000 Carey Lee Straetz	Managing Medicaid Rolls Often State-by-State Affair Despite the strong economy, Medicaid enrollment may be slowly rising after a three-year decline. The challenges for serving this population are huge.
Managed Care December 2007 John Carroll	How Doctors Are Paid Now, And Why It Has to Change Everyone knows about the perverse incentive of fee-for-service medicine, but that hasn't had much effect on its use.
Managed Care September 1999 Bruce J. Goldstein, J.D. & Mark D. Abruzzo, J.D.	Health Plans That Decredential Docs Must Do It Correctly and Expect a Fight
Managed Care May 2007	The Formulary Files The American Academy of Pediatrics predicts that the increasing costs of vaccines, combined with low payments from insurance companies, will lead to under-immunization.
Managed Care March 2005 Frank Diamond	Kaiser's Asthma Outcomes Will Take Your Breath Away The company's Mid-Atlantic States Region has seen impressive savings since launching a disease management program for asthma.
Managed Care June 2003 Alison Johnson	Measuring DM's Net Effect Is Harder Than You Might Think Disease management is God's gift to managed care. Or is it? Here is a discussion of areas that make evaluating a DM program a complex, if not ineffable, proposition.
HBS Working Knowledge July 14, 2006 Regina E. Herzlinger	The Case for Consumer-Driven Medicaid The Medicaid program is a health insurance safety net for 52 million Americans, but the price tag threatens the financial stability of the states. South Carolina provides a model in consumer-driven healthcare.
Managed Care September 1999 Frank Diamond Senior Editor	Florida Medicaid Moves Toward Direct Contracting Florida will soon test a program that could provide competition for HMOs serving the Medicaid population. Other states are watching.
Managed Care February 2002 Joyce Ochs	E-Prescribing Gets More Enticing Physicians today are writing prescriptions for patients on palm-held devices that seem eerily akin to medical practice on the Starship Enterprise...
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care April 2000 Bob Carlson	Many State Medicaid Agencies Use Financial Incentives To Boost Quality The days when state Medicaid agencies were bureaucratic establishments that paid claims and were unable to demand little better than institutional-style care are gone....
Managed Care March 2002 Mildred Beam-Rucker	'Team Approach' to Contract Talks Means That Nobody Feels Cheated Managed care is a business. Both parties want a profitable relationship, and while profitability is important, providers and managed care organizations seem to have more success when they identify a joint mission for the relationship and take a team approach to contracting...
Managed Care July 2004 Martin Sipkoff	Managed Medicaid Business Might Be Worth the Difficulties Financial, regulatory, and access problems continue. Still, this remains a growth industry and some have found a way to profit.
Managed Care May 2000	Texas-Aetna Incentives Settlement Worries Some Capitated Physicians If the Texas deal ignites a trend away from the use of incentives to keep utilization down, then some capitated physicians worry it will put them in a tight spot.
Managed Care January 2001 Bob Carlson	Ohio Struggles To Rescue Managed Medicaid Program Health plans and providers in Ohio's beleaguered Medicaid managed care program, OhioCare, welcomed its per-member, per-month payment increases of more than 25 percent over the last two years...
Managed Care April 2000	Cigna Colorado Ends Capitation For Most Primary Care Physicians In a strategic move aimed at retaining and recruiting top physicians, Cigna HealthCare of Colorado has dumped capitation. In late February, the insurer began paying most of its physicians in the state on a discounted fee-for-service basis....
Managed Care November 1999 Allen Briskin & Gerry Hinkley	HMO Liability Battleground Moving to Courts, Statehouse The adage "all politics is local" may, in the end, become the motto that sinks ERISA. HMO executives should assume protection will evaporate.
Managed Care February 2002	Computer Glitch Blocks Too Many Prescriptions Pharmacists in Massachusetts were hopping mad when a new computer system designed to help process prescriptions for Medicaid enrollees malfunctioned during its launch...
Managed Care September 2004 Michael D. Cabana et al.	Improving Physician Attendance At Educational Seminars Sponsored By Managed Care Organizations Although interactive educational seminars that target physicians require a large investment of resources, they can be cost-effective if medical care is improved as a result.
Managed Care December 2005 David S. Geldmacher	The Cost Benefit to Health Plans of Pharmacotherapy for Alzheimer's Disease As with other chronic diseases of aging, early diagnosis and pharmacologic therapy may reduce the costs for enrollees with Alzheimer's disease. This article reviews patient and caregiver outcomes associated with reduced health care costs and their implications for Managed Care Organizations.
Managed Care July 2002 Michael D. Dalzell	Has Capitation Weathered the Storm? More difficult than ever to pull off, health care on a fixed, per-capita budget has gone out of style in a number of areas. But many things are cyclical - and this trend may be, too.
Managed Care June 2003	For-profit, not-for-profit enrollment holding about steady While HMOs seemed to be losing enrollees to PPOs, the ratio of enrollees in for-profit and not-for-profit HMOs stabilized in the late 1990s, according to data collected by the Centers for Medicare and Medicaid Services.
Managed Care August 2004	Medicaid Fees Rise, But Still Below Medicare A recent study reports that 30 states raised their Medicaid fees at or above the rate of inflation, including 10 that raised physician fees by more than 35%.
Managed Care December 2001	CMS Medicaid Managed Care Proposal Under Close Scrutiny Bioterrorism. Medicaid managed care plans. No link between them? Guess again. It all has to do with how proposed Medicaid regulations would affect patients' rights and funding for Medicaid programs ranging from nursing home care to emergency rooms...
Managed Care July 2000	New Protections In California Not Helping Docs For all the talk of change in the state of California's ability to govern health care delivery, it appears that one group -- physicians -- is falling through the cracks.
Managed Care August 2004 Martin Sipkoff	Bad Tiered Formulary Designs Yield Poor Outcomes, High Cost Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
Managed Care December 2002	Providers turn to fee-for-service charges to make up revenue lost under capitation If there's any doubt whether capitation has left a bit of a sour taste in the mouths of physicians and hospitals, a survey issued earlier this year would seem to confirm it.
Managed Care January 2001 Richard B. Dwore	Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction...
Managed Care December 2007 Martin Sipkoff	Smoking Cessation Coverage May Be Worth Plans' Effort Programs that include a pharmacology benefit reap rewards for the health plan and the member. So why isn't there 100% buy-in?
Managed Care April 2002 Jeffrey J. Denning	Does Quality of Care Matter? You Bet! Determine and demonstrate your quality as a physician. Sure, it's unscientific to define quality and then measure it in your own practice. But this isn't the academy, this is business...
Managed Care August 2002	24 States Hope Pharmacy Plus Helps Medicaid Twenty-four states may gamble that providing a prescription drug program to low-income elderly who do not qualify for Medicaid could save them money in the long run.
Pharmaceutical Executive September 1, 2005 Tenaglia & Angelastro	No Margin for Error Pharmaceutical companies that will be forced to cut back on sales and marketing spending must focus on value, not volume. Here's how to reduce your spending where it matters the least.
Managed Care March 2004 John Carroll	Narrow Networks' Broader Vision Throughout the late 1990s, the fashion in managed care networks was bigger and bigger. These days, though, health plans around the country have begun sizing up so-called narrow networks once again.
Managed Care January 2001 David Ricks & Joe Suminski	Nowhere To Go but Out? Tracking Medicare+Choice Managed Medicare's trouble may have something to do with underfunding or rich benefits, but for health plans, market share has a lot to do with it, too...
BusinessWeek February 21, 2005 Howard Gleckman	The New Face Of Medicaid Seniors and the disabled are pushing the program to the breaking point.
Managed Care June 2001	Incentives make the difference During 2000, favorable incentive policies helped employees of integrated health plans to enjoy larger percentage increases in base pay and total cash compensation than employees of integrated health care providers...